{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:07:00Z","timestamp":1779322020520,"version":"3.51.4"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T00:00:00Z","timestamp":1771027200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"US National Institutes of Health's National Institute of Allergy and Infectious Diseases"},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["U01AI069924"],"award-info":[{"award-number":["U01AI069924"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"publisher","award":["193381"],"award-info":[{"award-number":["193381"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"publisher","award":["P500PM_210933"],"award-info":[{"award-number":["P500PM_210933"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013362","name":"Swiss Cancer Research foundation","doi-asserted-by":"publisher","award":["KFS-S 447-08-2021"],"award-info":[{"award-number":["KFS-S 447-08-2021"]}],"id":[{"id":"10.13039\/501100013362","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Women with human immunodeficiency virus-1 (HIV) (WWH) have a higher cervical cancer risk than women without HIV. The timing and extent to which HIV viremia and immunodeficiency contribute to cervical carcinogenesis remain incompletely understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cohort study using medical claims data from a South African HIV program (2011\u20132022) and calculated incidence rates of cervical precancer and cancer. Cox proportional hazards models assessed associations with CD4 cell count and HIV ribonucleic acid (RNA). We tested summary and point-in-time CD4 and HIV RNA measures with 6\u201336 months lag periods. Models were adjusted for age, calendar year, and antiretroviral therapy (ART) initiation; fully adjusted models included both CD4 count and HIV RNA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over 66 000 WWH contributed more than 300 000 person-years; 1202 WWH developed moderate dysplasia (incidence rate: 394\/100 000 person-years), 1237 severe dysplasia (405\/100 000 person-years), 211 carcinoma in situ (66\/100 000 person-years), and 257 cervical cancer (70\/100 000 person-years). Lower CD4 counts were strongly associated with higher rates of cervical dysplasia, carcinoma in situ, and cancer, independent of HIV RNA. Lowest CD4 count over 30 months was the most informative measure for cervical dysplasia while CD4 count lagged by 24 months was most informative for cervical cancer. Higher HIV RNA was associated with increased risk of precancer and cancer in models unadjusted for CD4 count, with associations attenuated after adjustment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Maintaining high CD4 counts and achieving viral suppression through early ART initiation, along with using CD4 cell count for risk stratification in cervical screening, may help improve cervical cancer prevention among WWH in South Africa.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciag093","type":"journal-article","created":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T06:45:30Z","timestamp":1771051530000},"page":"e976-e983","source":"Crossref","is-referenced-by-count":0,"title":["Association of Immunodeficiency and HIV Viremia With Cervical Precancer and Cancer Risk Among Women With HIV in South Africa"],"prefix":"10.1093","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0891-2448","authenticated-orcid":false,"given":"Yann","family":"Ruffieux","sequence":"first","affiliation":[{"name":"Institute of Social and Preventive Medicine, University of Bern , Bern ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2770-0061","authenticated-orcid":false,"given":"John","family":"Andoh","sequence":"additional","affiliation":[{"name":"Institute of Social and Preventive Medicine, University of Bern , Bern ,","place":["Switzerland"]},{"name":"Graduate School for Health Sciences, University of Bern , Bern ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4849-181X","authenticated-orcid":false,"given":"Andreas D","family":"Haas","sequence":"additional","affiliation":[{"name":"Institute of Social and Preventive Medicine, University of Bern , Bern ,","place":["Switzerland"]},{"name":"Centre for Integrated Data and Epidemiological Research, School of Public Health, University of Cape Town , Cape Town ,","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1560-7580","authenticated-orcid":false,"given":"Chido","family":"Chinogurei","sequence":"additional","affiliation":[{"name":"Centre for Integrated Data and Epidemiological Research, School of Public Health, University of Cape Town , Cape Town ,","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0812-0069","authenticated-orcid":false,"given":"Katayoun","family":"Taghavi","sequence":"additional","affiliation":[{"name":"Institute of Social and Preventive Medicine, University of Bern , Bern ,","place":["Switzerland"]},{"name":"Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, World Health Organization (IARC\/WHO) , Lyon ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cari","family":"van Schalkwyk","sequence":"additional","affiliation":[{"name":"South African Centre for Epidemiological Modelling and Analysis (SACEMA), Centre for Epidemic Response and Innovation (CERI), School for Data Science and Computational Thinking, Stellenbosch University , Stellenbosch ,","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7462-5132","authenticated-orcid":false,"given":"Matthias","family":"Egger","sequence":"additional","affiliation":[{"name":"Institute of Social and Preventive Medicine, University of Bern , Bern ,","place":["Switzerland"]},{"name":"Population Health Sciences, Bristol Medical School, University of Bristol , Bristol ,","place":["United Kingdom"]},{"name":"Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2667-0956","authenticated-orcid":false,"given":"Naomi","family":"Folb","sequence":"additional","affiliation":[{"name":"Medscheme , Cape Town ,","place":["South Africa"]},{"name":"Division of Clinical Pharmacology, Department of Medicine, University of Cape Town , Cape Town ,","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3080-6606","authenticated-orcid":false,"given":"Gary","family":"Maartens","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine, University of Cape Town , Cape Town ,","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0554-2875","authenticated-orcid":false,"given":"Eliane","family":"Rohner","sequence":"additional","affiliation":[{"name":"Institute of Social and Preventive Medicine, University of Bern , Bern ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,2,14]]},"reference":[{"key":"2026052019253935000_ciag093-B1","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1093\/jnci\/djq562","article-title":"Human papillomavirus testing in the prevention of cervical cancer","volume":"103","author":"Schiffman","year":"2011","journal-title":"J Natl Cancer Inst"},{"key":"2026052019253935000_ciag093-B2","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1097\/QAD.0000000000001765","article-title":"HIV-positive women have higher risk of human papilloma virus infection, precancerous lesions, and cervical 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